Upscheduling of codeine

Resources to help support GPs and their patients

From 1 February 2018, medicines containing codeine will no longer be available to consumers over the counter at pharmacies.

The Therapeutic Goods Administration (TGA) upscheduled codeine to a Schedule 4 prescription only drug because of evidence about its safety and effectiveness. Evidence shows that over the counter medicines containing codeine provide little additional benefit in pain relief in comparison to other similar medicines without codeine. Furthermore, codeine can be addictive and with regular use, patients can become dependent on it, leading to misuse and in extreme cases, death. In Australia, there are over 150 codeine related deaths per year.

The RACGP supported the TGA’s decision, as did the Consumers Health Forum, Pain Australia and all the major medical groups.

The change will bring Australia into line with many other countries in the world, where codeine is only available with a prescription. This includes the USA, Japan, India and much of Europe.

Pain management is a core general practitioner skill. But the complex (and sometimes controversial) nature of pain, particularly the management of chronic pain, can push the limits of this skill. Drug therapies will only ever have a partial role in managing complex biopsychosocial issues that characterise pain management. In the modern health environment, we must explore and use non-drug therapies, and redefine the place for existing medications.

Requiring patients to have a prescription for medicines containing codeine will provide the opportunity for GPs to:

talk to their patients about managing their pain more effectively and safely

provide help and support for patients with addiction issues

develop an appropriate management plan that can be reviewed on a regular basis.

We have compiled a list of available resources to help support you, your practice, and your patients with this change.